University of San Francisco California
Employment Questions
AAFP Social Needs Screening Tool
Do you have a job?
Yes/ No
AccessHealth: Spartanburg Screening Tool
Are you currently employed?
ACORN Screening Tool
Do you want help finding or keeping work or a job?
Yes, help finding work
Yes, help keeping work
No, I don’t want help finding or keeping work
Accountable Health Communities Health-Related Social Needs Screening Tool
Supplemental: Do you want help finding or keeping work or a job?
Yes, help finding work
Yes, help keeping work
I do not need or want help
Boston Medical Center-Thrive Screening Tool
Are you currently unemployed and looking for a job?
Yes/ No
HealthBegins Upstream Risk Screening Tool
Which best describes your current occupation?
Homemaker, not working outside the home
Employed (or selfemployed) full time
Employed (or selfemployed) part time
Employed, but on leave for health reasons
Employed but temporarily away from my job (other than health reasons)
Unemployed or laid off 6 months or less
Unemployed or laid off more than 6 months
Unemployed due to a disability
Retired from my usual occupation and not working
Retired from my usual occupation but working for pay
Retired from my usual occupation but volunteering
Medical-Legal Partnership IHELLP
Please indicate if the following describes a concern you have related to employment.
I am unable to earn income as a result of a disability.
PRAPARE
What is your current work situation?
Unemployed
Part-time or Temporary Work
Full-time work
Otherwise unemployed but not seeking work (ex: student, retired, disabled, unpaid primary care giver) Please write:
Structural Vulnerability Assessment Tool
How do you make money?
Do you have a hard time doing this work?
Are there other ways you make money?
WellRx Toolkit
Are you unemployed or without regular income?
Yes/No
Do you need help finding a better job?
Yes/No